摘要
目的间接法建立健康人群甲状腺激素生物参考区间,探讨目前生物参考区间对中老年人群的适用性,为临床提供更为精确的诊疗依据。方法收集2016年1月~2019年12月于北京老年医院行健康体检者的甲状腺功能指标,包括促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、总三碘甲状腺原氨酸(TT3)、游离甲状腺素(FT4)和总甲状腺素(TT4)。采用非参数法自建其参考区间,并与现有参考区间进行比较。结果除TT4外,FT3、FT4、TT3、TSH在性别间的差异均有统计学意义(P<0.05)。其中女性TSH水平高于男性,而FT3、FT4、TT3低于男性。在女性人群中,TSH、FT4、FT3甲状腺功能指标在不同年龄组间比较,差异均有统计学意义(P<0.05);在男性人群,TT3、FT3指标在不同年龄组间比较,差异均有统计学意义(P<0.05),而TSH、FT4、TT4指标各组间比较,差异均无统计学意义(P>0.05)。不同年龄组间比较发现,无论男性或女性,>70岁组FT3水平均低于其他3个年龄组,差异均有统计学意义(P<0.05);在男性人群中,>70岁组TT3水平低于≤50岁组及51~60岁组,差异均有统计学意义(P<0.05);女性人群中,61~70岁组TSH高于≤50岁组,>70岁组TT3水平低于其他3个年龄组,>70岁组FT4水平高于≤50岁组及51~60岁组,差异有统计学意义(P<0.05)。自建甲状腺激素参考区间,男性:TSH 0.77~3.82 mIU/L,FT412.87~20.93 pmol/L,FT34.05~6.24 pmol/L,TT31.26~2.16 nmol/L,TT472.07~140.30 nmol/L;女性:TSH 0.80~4.20 mIU/L,FT412.43~20.15 pmol/L,FT34.01~5.80 pmol/L,TT31.23~2.10 nmol/L,TT472.07~138.99 nmol/L。结论甲状腺激素水平存在性别、年龄差异;实验室参考区间与现有参考区间存在差异,是否按性别年龄分别设立参考区间有待进一步研究。
Objective To establish biological reference intervals of thyroid hormone in healthy population by indirect method,and discuss the applicability of current biological reference intervals to the middle-aged and older people,so as to provide a more accurate basis for clinical diagnosis and treatment.Methods The data of thyroid function indicators were collected from 1035 people undergoing health check-up from January 2016 to December 2019 in Beijing Geriatric Hospital,including the levels of thyroid stimulating hormone(TSH),free triiodothyronine(FT3),total triiodothyronine(TT3),free thyroxine(FT4)and total thyroxine(TT4).Non-parametric method was performed to get the reference intervals and compared them with the current ones.Results FT3,FT4,TT3,and TSH levels were significantly different between females and males(P<0.05).TSH level in females was higher than that in males,while FT3,FT4 and TT3 levels were lower than those in males.In the female population,except for TT4,the levels of other thyroid function indices were statistically different between different age groups(P<0.05).In the male population,the levels of TT3 and FT3 were statistically different between different age groups(P<0.05),while there were no significant differences in the levels of TSH,FT4 and TT4(P>0.05).The comparison between different age groups showed that FT3 level in group>70 years old was lower than that in the other three age groups in both males and females(P<0.05).In the male population,TT3 level in group>70 years old was lower than that in group≤50 years old and group 51-60 years old(P<0.05).In the female population,TSH level in group 61-70 years old was higher than that in group≤50 years old,TT3 level in group>70 years old was lower than that in the other three age groups,FT4 level in group>70 years old was higher than that in group≤50 years old and group 51-60 years old.The differences were statistically significant(P<0.05).The self-established reference intervals for males were for TSH 0.77-3.82 mIU/L,for FT412.87-20.93 pmol/L
作者
翁绳凤
李宁
宋洋
Weng Shengfeng;Li Ning;Song Yang(Department of Laboratory,Beijing Geriatric Hospital,Beijing 100095)
出处
《国际老年医学杂志》
2023年第2期182-186,共5页
International Journal of Geriatrics
基金
北京老年医院科研专项(2019bjlnyy-自-1)。
关键词
间接法
甲状腺激素
参考区间
建立
Indirect method
Thyroid hormone
Reference interval
Establishment
